Eficácia e gestão da política de atenção básica de saúde nos municípios brasileiros / Effectiveness of policy and management of basic health care in municipalities

AUTOR(ES)

Sandro Garcia Duarte Peixoto

DATA DE PUBLICAÇÃO

2008

RESUMO

This research investigates two aspects of Brazilian primary health care policy: estimates its impact on municipalities health indicators and analysis the quality on policy management. Primary health care policy consists in an essential foundation of SUS (health care system), as it embraces a wide range of activities focused on preventive care. Besides that, once municipalities are in charge of providing primary care to inhabitants, the policy contributes to scatter attendance over the country and to organize municipals health systems. Our estimates were developed on a panel data approach based on southeastern municipalities data from 1999 to 2003. The coverage of Programa Saude da Familia (Family Health Program) and Programa de Agentes Comunitarios de Saude (Health Community Agents Program) are used as proxies of primary health care presence on each locality. Our results show the negative impact of primary care both on infant mortality and underreporting of deaths (among the whole population), but they suggest primary care policy did not reduce hospitalization. In what concerns policy management, our analysis was settled on reports developed by the Federal Agency Controladoria Geral da Uniao under its Inspection on States and Municipalities by means of Public Lottery Program. Our main conclusion is that programs design rears low incentives for city citizens to inspect resources expended on primary care. Due to policy funding structure, in which Federal Government finances most of total expenses, local citizens do not internalize its cost-benefit analysis. Besides that, low transparency, inadequate inspection and unlikely punishment for individuals caught committing irregularities inhibit proper management practices adoption.

ASSUNTO(S)

panel data econometrics and public management econometria primary health care saúde da família economia da saúde administração em saúde pública

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